Bill Text: CA SB1407 | 2011-2012 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Medical information: disclosure.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Passed) 2012-09-27 - Chaptered by Secretary of State. Chapter 657, Statutes of 2012. [SB1407 Detail]

Download: California-2011-SB1407-Amended.html

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BILL NUMBER: SB 1407	AMENDED
	BILL TEXT

	AMENDED IN SENATE  MARCH 29, 2012

INTRODUCED BY   Senator Leno

                        FEBRUARY 24, 2012

    An act to amend Section 10601.2 of the Welfare and
Institutions Code, relating to public social services.  
An act to amend Section 56.11 of the Civil Code, to amend Section
123105 of the Health and Safety Code, and to amend Sections 280 and
281 of the Welfare and Institutions Code, relating to medical
informat   ion. 



	LEGISLATIVE COUNSEL'S DIGEST


   SB 1407, as amended, Leno.  Child welfare: child and
family service reviews.   Medical information:
disclosure.  
   (1) Existing law governs the release of a patient's medical
records and medical information by a health care provider, health
care service plan, pharmaceutical company, or provider. Under
existing law, a patient may inspect his or her medical records if the
patient or his or her representative, as defined, presents a written
request to the health care provider. Existing law also authorizes a
health care provider, health care service plan, pharmaceutical
company, or contractor to release a patient's medical information
after receiving a valid signed authorization from the patient, the
patient's legal representative, as defined, if the patient is a minor
or incompetent, and other specified individuals. Existing law
provides that a minor may be removed from the physical custody of his
or her parents in dependency proceedings if there is a substantial
danger to the physical health of the child or the child is suffering
severe emotional damage and there are no reasonable means to protect
the child without removing him or her.  
   This bill would provide that a minor patient's parent shall not be
considered the minor's representative for medical information
release purposes if the minor has been removed from that parent's
physical custody in dependency proceedings.  
   (2) Existing law requires a juvenile probation officer in a
dependency or delinquency proceeding to prepare a social study, which
includes a recommendation for disposition of that case, for
disposition hearings. Under existing law, the juvenile court may also
order the probation officer to file other written reports and
recommendations concerning a minor's custody, status, or welfare.
Existing law permits disclosure of medical information to a county
social worker, probation officer, or any other person who is legally
authorized to have custody or care of a minor for the purpose of
coordinating the minor's health care services and medical treatment,
including mental health and developmental disability services. 

   This bill would expand the requirement that a juvenile probation
officer prepare a social study to include any disposition hearing in
a case involving a nonminor dependent of the court. The bill would
also prohibit the probation officer from including any privileged
information in the report, including information relating to the
minor's health care and mental health treatment, unless the holder of
the privilege validly waives that privilege. By increasing the
duties of local probation officers to include social studies for
cases involving nonminor dependents, this bill would impose a
state-mandated local program.  
   (3) The California Constitution requires the state to reimburse
local agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.  
   This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.  
    Under existing law, the state, through the State Department of
Social Services and county welfare departments, is required to
establish and support a public system of statewide child welfare
services for the protection of children. Existing law also requires
the department to establish the California Child and Family Service
Review System to review all county child welfare systems. 

   This bill would make a nonsubstantive, technical change to that
provision. 
   Vote: majority. Appropriation: no. Fiscal committee:  no
  yes  . State-mandated local program:  no
  yes  .


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 56.11 of the   Civil
Code   is amended to read: 
   56.11.  Any person or entity that wishes to obtain medical
information pursuant to subdivision (a) of Section 56.10, other than
a person or entity authorized to receive medical information pursuant
to subdivision (b) or (c) of Section 56.10, except as provided in
paragraph (21) of subdivision (c) of Section 56.10, shall obtain a
valid authorization for the release of this information.
   An authorization for the release of medical information by a
provider of health care, health care service plan, pharmaceutical
company, or contractor shall be valid if it:
   (a) Is handwritten by the person who signs it or is in a typeface
no smaller than 14-point type.
   (b) Is clearly separate from any other language present on the
same page and is executed by a signature which serves no other
purpose than to execute the authorization.
   (c) Is signed and dated by one of the following:
   (1) The patient. A patient who is a minor may only sign an
authorization for the release of medical information obtained by a
provider of health care, health care service plan, pharmaceutical
company, or contractor in the course of furnishing services to which
the minor could lawfully have consented under Part 1 (commencing with
Section 25) or Part 2.7 (commencing with Section 60).
   (2) The legal representative of the patient, if the patient is a
minor or an incompetent. However, authorization may not be given
under this subdivision for the disclosure of medical information
obtained by the provider of health care, health care service plan,
pharmaceutical company, or contractor in the course of furnishing
services to which a minor patient could lawfully have consented under
Part 1 (commencing with Section 25) or Part 2.7 (commencing with
Section 60).  A parent or guardian is not considered the legal
representative of a minor patient for purposes of this paragraph if
the minor has been removed from the physical custody of the parent or
guardian pursuant to Section 300 of the Welfare and Institutions
Code. 
   (3) The spouse of the patient or the person financially
responsible for the patient, where the medical information is being
sought for the sole purpose of processing an application for health
insurance or for enrollment in a nonprofit hospital plan, a health
care service plan, or an employee benefit plan, and where the patient
is to be an enrolled spouse or dependent under the policy or plan.
   (4) The beneficiary or personal representative of a deceased
patient.
   (d) States the specific uses and limitations on the types of
medical information to be disclosed.
   (e) States the name or functions of the provider of health care,
health care service plan, pharmaceutical company, or contractor that
may disclose the medical information.
   (f) States the name or functions of the persons or entities
authorized to receive the medical information.
   (g) States the specific uses and limitations on the use of the
medical information by the persons or entities authorized to receive
the medical information.
   (h) States a specific date after which the provider of health
care, health care service plan, pharmaceutical company, or contractor
is no longer authorized to disclose the medical information.
   (i) Advises the person signing the authorization of the right to
receive a copy of the authorization.
   SEC. 2.    Section 123105 of the   Health
and Safety Code   is amended to read: 
   123105.  As used in this chapter:
   (a) "Health care provider" means any of the following:
   (1) A health facility licensed pursuant to Chapter 2 (commencing
with Section 1250) of Division 2.
   (2) A clinic licensed pursuant to Chapter 1 (commencing with
Section 1200) of Division 2.
   (3) A home health agency licensed pursuant to Chapter 8
(commencing with Section 1725) of Division 2.
   (4) A physician and surgeon licensed pursuant to Chapter 5
(commencing with Section 2000) of Division 2 of the Business and
Professions Code or pursuant to the Osteopathic Act.
   (5) A podiatrist licensed pursuant to Article 22 (commencing with
Section 2460) of Chapter 5 of Division 2 of the Business and
Professions Code.
   (6) A dentist licensed pursuant to Chapter 4 (commencing with
Section 1600) of Division 2 of the Business and Professions Code.
   (7) A psychologist licensed pursuant to Chapter 6.6 (commencing
with Section 2900) of Division 2 of the Business and Professions
Code.
   (8) An optometrist licensed pursuant to Chapter 7 (commencing with
Section 3000) of Division 2 of the Business and Professions Code.
   (9) A chiropractor licensed pursuant to the Chiropractic
Initiative Act.
   (10) A marriage and family therapist licensed pursuant to Chapter
13 (commencing with Section 4980) of Division 2 of the Business and
Professions Code.
   (11) A clinical social worker licensed pursuant to Chapter 14
(commencing with Section 4990) of Division 2 of the Business and
Professions Code.
   (12) A physical therapist licensed pursuant to Chapter 5.7
(commencing with Section 2600) of Division 2 of the Business and
Professions Code.
   (13) An occupational therapist licensed pursuant to Chapter 5.6
(commencing with Section 2570).
   (14) A professional clinical counselor licensed pursuant to
Chapter 16 (commencing with Section 4999.10) of Division 2 of the
Business and Professions Code.
   (b) "Mental health records" means patient records, or discrete
portions thereof, specifically relating to evaluation or treatment of
a mental disorder. "Mental health records" includes, but is not
limited to, all alcohol and drug abuse records.
   (c) "Patient" means a patient or former patient of a health care
provider.
   (d) "Patient records" means records in any form or medium
maintained by, or in the custody or control of, a health care
provider relating to the health history, diagnosis, or condition of a
patient, or relating to treatment provided or proposed to be
provided to the patient. "Patient records" includes only records
pertaining to the patient requesting the records or whose
representative requests the records. "Patient records" does not
include information given in confidence to a health care provider by
a person other than another health care provider or the patient, and
that material may be removed from any records prior to inspection or
copying under Section 123110 or 123115. "Patient records" does not
include information contained in aggregate form, such as indices,
registers, or logs.
   (e) "Patient's representative" or "representative" means any of
the following:
   (1) A parent or guardian of a minor who is a patient  , 
 unless the minor patient has been removed from the physical
custody of the parent or guardian pursuant to Section 300 of the
Welfare and Institutions Code. 
   (2) The guardian or conservator of the person of an adult patient.

   (3) An agent as defined in Section 4607 of the Probate Code, to
the extent necessary for the agent to fulfill his or her duties as
set forth in Division 4.7 (commencing with Section 4600) of the
Probate Code.
   (4) The beneficiary as defined in Section 24 of the Probate Code
or personal representative as defined in Section 58 of the Probate
Code, of a deceased patient.
   (f) "Alcohol and drug abuse records" means patient records, or
discrete portions thereof, specifically relating to evaluation and
treatment of alcoholism or drug abuse.
   SEC. 3.    Section 280 of the   Welfare and
Institutions Code   is amended to read: 
   280.   (a)    Except where waived by the
probation officer, judge, or referee and the minor, the probation
officer shall be present in court to represent the interests of each
person who is the subject of a petition to declare that person to be
a ward or dependent child upon all hearings or rehearings of his or
her case, and shall furnish to the court such information and
assistance as the court may require. If so ordered, the probation
officer shall take charge of that person before and after any hearing
or rehearing. 
   It 
    (b)    It shall be the duty of the probation
officer to prepare for every hearing on the disposition of a case
 a social study of the minor, containing any matters that may be
relevant to a proper disposition of the case,  as provided by
Section 356, 358, 358.1, 361.5, 364, 366, 366.2,  or
 366.21  , 366.22, 366.25, 366.26, 366.3, 391, 702, or
any other hearing for a dependent minor or nonminor dependent if a
social study is required by law,  as is appropriate for the
specific hearing  , or, for a hearing as provided by Section
702, a social study of the minor, containing such matters as may be
relevant to a proper disposition of the case  . The social
study shall include a recommendation for the disposition of the case
 , but shall not contain any information that is privileged
pursuant to Division 8 (commencing with Section 900) of the Evidence
Code, including, but not limited to, p   rivileged
information that is already contained in the probation or child
welfare file, or information obtained pursuant to Section 56.103 of
the Civil Code or Section 5328.04, unless there is a valid waiver by
the holder of the privilege  .
   SEC. 4.   Section 281 of the   Welfare and
Institutions Code   is amended to read: 
   281.   (a)    The probation officer shall  ,
 upon order of any court in any matter involving the custody,
status, or welfare of a minor or minors, make an investigation of
appropriate facts and circumstances and prepare and file with the
court written reports and written recommendations in reference to
 such   those  matters. The court is
authorized to receive and consider the reports and recommendations of
the probation officer in determining any  such matter.
  of those matters.  
   (b) A written report under this section shall not include any
information that is privileged pursuant to Division 8 (commencing
with Section 900) of the Evidence Code, including, but not limited
to, privileged information already contained in the probation or
child welfare file, or information obtained pursuant to Section
56.103 of the Civil Code or Section 5328.04, unless there is a valid
waiver by the holder of the privilege. 
   SEC. 5.    If the Commission on State Mandates
determines that this act contains costs mandated by the state,
reimbursement to local agencies and school districts for those costs
shall be made pursuant to Part 7 (commencing with Section 17500) of
Division 4 of Title 2 of the Government Code.  
  SECTION 1.    Section 10601.2 of the Welfare and
Institutions Code is amended to read:
   10601.2.  (a) The State Department of Social Services shall
establish, by April 1, 2003, the California Child and Family Service
Review System, to review all county child welfare systems. These
reviews shall cover child protective services, foster care, adoption,
family preservation, family support, and independent living.
   (b) Child and family service reviews shall maximize compliance
with the federal regulations for the receipt of money from Subtitle E
(commencing with Section 470) of Title IV of the federal Social
Security Act (42 U.S.C. Sec. 670 and following) and ensure compliance
with state plan requirements set forth in Subtitle B (commencing
with Section 421) of Title IV of the federal Social Security Act (42
U.S.C. Sec. 621 and following).
   (c) (1) By October 1, 2002, the California Health and Human
Services Agency shall convene a workgroup comprised of
representatives of the Judicial Council, the State Department of
Social Services, the State Department of Health Care Services, the
State Department of Mental Health, the State Department of Education,
the Department of Child Support Services, the State Department of
Justice, any other state departments or agencies the California
Health and Human Services Agency deems necessary, the County Welfare
Directors Association, the California State Association of Counties,
the Chief Probation Officers of California, the California Youth
Connection, and representatives of California tribes, interested
child advocacy organizations, researchers, and foster parent
organizations. The workgroup shall establish a workplan by which
child and family service reviews shall be conducted pursuant to this
section, including a process for qualitative peer reviews of case
information.
   (2) At a minimum, in establishing the workplan, the workgroup
shall consider any existing federal program improvement plans entered
into by the state pursuant to federal regulations, the outcome
indicators to be measured, compliance thresholds for each indicator,
timelines for implementation, county review cycles, uniform
processes, procedures and review instruments to be used, a corrective
action process, and any funding or staffing increases needed to
implement the requirements of this section. The agency shall broadly
consider collaboration with all entities to allow the adequate
exchange of information and coordination of efforts to improve
outcomes for foster youth and families.
   (d) (1) The California Child and Family Service Review System
outcome indicators shall be consistent with the federal child and
family service review measures and standards for child and family
outcomes and system factors authorized by Subtitle B (commencing with
Section 421) and Subtitle E (commencing with Section 470) of Title
IV of the federal Social Security Act and the regulations adopted
pursuant to those provisions (Parts 1355 to 1357, inclusive, of Title
45 of the Code of Federal Regulations).
   (2) During the first review cycle pursuant to this section, each
county shall be reviewed according to the outcome indicators
established for the California Child and Family Service Review
System.
   (3) For subsequent reviews, the workgroup shall consider whether
to establish additional outcome indicators that support the federal
outcomes and any program improvement plan, and promote good health,
mental health, behavioral, educational, and other relevant outcomes
for children and families in California's child welfare services
system.
   (e) The State Department of Social Services shall identify and
promote the replication of best practices in child welfare service
delivery to achieve the measurable outcomes established pursuant to
subdivision (d).
   (f) The State Department of Social Services shall provide
information to the Assembly and Senate Budget Committees and
appropriate legislative policy committees annually, beginning with
the 2002-03 fiscal year, on all of the following:
   (1) The department's progress in planning for the federal child
and family service review to be conducted by the United States
Department of Health and Human Services and, upon completion of the
federal review, the findings of that review, the state's response to
the findings, and the details of any program improvement plan entered
into by the state.
   (2) The department's progress in implementing the California child
and family service reviews, including, but not limited to, the
timelines for implementation, the process to be used, and any funding
or staffing increases needed at the state or local level to
implement the requirements of this section.
   (3) The findings and recommendations for child welfare system
improvements identified in county self-assessments and county system
improvement plans, including information on common statutory,
regulatory, or fiscal barriers identified as inhibiting system
improvements, any recommendations to overcome those barriers, and, as
applicable, information regarding the allocation and use of the
moneys provided to counties pursuant to subdivision (i).
   (g) Effective April 1, 2003, the existing county compliance review
system shall be suspended to provide to the State Department of
Social Services sufficient lead time to provide training and
technical assistance to counties for the preparation necessary to
transition to the new child and family service review system.
   (h) Beginning January 1, 2004, the department shall commence
individual child and family service reviews of California counties.
County child welfare systems that do not meet the established
compliance thresholds for the outcome measures that are reviewed
shall receive technical assistance from teams made up of state and
peer-county administrators to assist with implementing best practices
to improve their performance and make progress toward meeting
established levels of compliance.
   (i) (1) To the extent that funds are appropriated in the annual
Budget Act to enable counties to implement approaches to improve
their performance on the outcome indicators under this section, the
department, in consultation with counties, shall establish a process
for allocating the funds to counties.
   (2) The allocation process shall take into account, at a minimum,
the extent to which the proposed funding would be used for activities
that are reasonably expected to help the county make progress toward
the outcome indicators established pursuant to this section, and the
extent to which county funding for the Child Abuse, Prevention and
Treatment program is aligned with the outcome indicators.
   (3) To the extent possible, a county shall use funds allocated
pursuant to this subdivision in a manner that enables the county to
access additional federal, state, and local funds from other
available sources. However, a county's ability to receive additional
matching funds from these sources shall not be a determining factor
in the allocation process established pursuant to this subdivision.
   (4) The department shall provide information to the appropriate
committees of the Legislature on the process established pursuant to
this subdivision for allocating funds to counties.